Friday, 13 March 2015

WHO First Treatment Guidelines For Hepatitis B Disease


The WHO on Thursday, released its first-ever guidance for the treatment of chronic hepatitis B, a  viral infection which is transmitted through blood and body fluids.
Hepatitis B virus selectively attacks the liver and can lead to liver cirrhosis and cancer (hepatocellular carcinoma) without proper treatment.

Some drugs had previously been approved for use in the treatment of hepatitis B disease. However, in resource-poor countries, some of these drugs were not accessible.

The "WHO guidelines for the prevention, care and treatment of persons living with chronic hepatitis B infection" lay out a simplified approach to the care of people living with chronic hepatitis B, particularly in settings with limited resources.

Key recommendations include:
  • the use of a few simple non-invasive tests to assess the stage of liver disease to help identify who needs treatment; 
  • prioritizing treatment for those with cirrhosis - the most advanced stage of liver disease; 
  • the use of two safe and highly effective medicines, tenofovir or entecavir, for the treatment of chronic hepatitis B; and
  • regular monitoring using simple tests for early detection of liver cancer, to assess whether treatment is working, and if treatment can be stopped.
The preferred drugs that are recommended in the guidelines are tenofovir and entecavir. They have a very low risk of developing drug resistance, are easy to take as one pill once a day, and have few side effects. Both medicines are available as generics, and tenofovir is also used to treat HIV. 

WHO is recommending two types of non-invasive tests to assess the stage of liver disease to help identify who needs treatment. One type is based on blood tests (APRI – aspartate aminotransferase [AST]-to-platelet ratio index) and the other is a test based on a scan (Transient elastography e.g. FibroScan).

Source- WHO

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